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healthcare

Neurorehabilitation at Brotzu: the ghost ward and the "failed" scientific studies

Beds for the very seriously ill are foreseen, but the structure does not exist. Transferred patients. And the chief physician ends up at the center of international disputes: his publications have been withdrawn because they are considered "unreliable"
Henry Fresu
22 gennaio 2023 alle 15:33Aggiornato il 22 gennaio 2023 alle 15:11
Neurorehabilitation at Brotzu: the ghost ward and the "failed" scientific studies
L'ospedale Brotzu (L'Unione Sarda)
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At Brotzu there was a department and it no longer exists. Reason: unclear. There were also studies published in prestigious international scientific journals and they have been withdrawn. The reason: ended up at the center of a high-level academic dispute, they were deemed unreliable.

The connection between the two events is Marco Monticone, professor of physical and rehabilitation medicine at the University of Cagliari: he is the director of Neurorehabilitation at Arnas, the "disappeared" department, but also the author of the disavowed publications - so far without reply - by a team of researchers from Brunel University in London. And while professors are fleas - with failures that appear quite resounding - the south of Sardinia is left without a fundamental health service: patients with serious brain injuries, caused by strokes or accidents, are transferred. Even if the money to set up the ward has been spent and the staff is on hand.

THE GHOST DEPARTMENT. "Neurorehabilitation is a vital department for a hospital like San Michele and it doesn't deserve that power games are played around its top management". Franco Meloni knows Brotzu well. He also led him as general manager. And now on his blog he reconstructs the strange ups and downs of the department, as the regional councilor of the Progressives, Francesco Agus, did through a series of questions.

Neurorehabilitation was on the first floor, then it was moved to the seventh, in view of the definitive transfer to a space at the Businco: "About 300 thousand euros of public money were spent", underlines the former manager. But the move did not take place. In the meantime, to deal with the Covid emergency, in those spaces of the Oncology "the Center for Multiple Sclerosis from the Binaghi hospital was housed, by decision of the Health Department". Neurorehabilitation was closed «and the personnel assigned to the central Rehabilitation service». In the workforce also «a director who, following a special agreement stipulated in 2018, was a professor at the University of Cagliari, According to Meloni "the top management of the company (even if they will perhaps deny it out of official duty), were not exactly satisfied with the assistance functions performed by Monticone who, apparently, preferred - understandably from a certain point of view - to devote himself to his duties as a researcher rather than the tedious duties of a purely charitable nature". The exponent of the Reformers then adds that

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IN THE REGIONAL COUNCIL. Francesco Agus has also dealt with the subject on several occasions. In the reorganization of the hospital network, 24 neurorehabilitation beds, «compared to the existing 12, should have been in the complex structure of the Brotzu. Almost 400,000 euros were then allocated in 2018 for the functional remodulation of the Businco and the reorganization of the spaces for welcoming the structure», he wrote in March last year, « while the places currently available in Sardinia are only a few in Oristano and those pertaining to Mater Olbia. There is total uncertainty about the definitive destination of the complex structure».

Little has changed since then: the company lets it be known that there is currently no space dedicated to the ward, but the staff follows the patients where they are hospitalised. Agus and Meloni see it differently: they talk about continuous transfers for the most serious cases.

THE PROFESSOR. "I'm sick, I can't answer." There was an attempt to have Monticone's version. More than one. The professor, contacted by telephone, initially hides behind internal regulations – of the university and of the hospital – which would not allow him to speak to the press. Then, after jotting down the questions, he asks for a few days to ponder the answers. Who do not arrive: the phone rings empty and messages remain one-sided.

One of the questions was: «What can you say about your scientific publications that have been withdrawn by the journal editors?». This is how it works in the world of research: teachers and researchers study, analyse, elaborate theses, which are then reported in accredited specialized publications and increase fame, guaranteeing a career. Monticone, who deals with diseases of the musculoskeletal system and physical and rehabilitation medicine, heads a research team and is the author of numerous publications on the subject.

Ten of these, on pain management, have come under the lens of other researchers, from Brunel University in London, led by Neil O'Connell. The result of their work was published in April 2022 in Pain magazine. Their thesis is: "The studies had several inconsistencies, including data that diverged from nearly all similar studies." It also noted "impossible statistical significance values and duplicate or very similar data from other studies in the group, although the studies were presumably separate clinical trials." In short, the accounts did not add up.

WITHDRAWAL. The scientific world has wondered about the goodness of Monticone's research work. And the reactions came: at least three of the disputed studies have been withdrawn. In two cases the magazine intervened, in another the decision was taken by the author. Traces of withdrawals remain. And one of the newspapers refers to the study that dismantled the work of the professor of the Cagliari university: « The concerns relate to the retrospective registration of the trial, the lack of clarity as to whether a trial protocol has been developed and whether a committee suitably qualified research ethicist has evaluated such a protocol . Sharing the "concerns", the article was withdrawn. Another scientific text was retracted by Monticone himself «because an error in the management of the data was noticed in retrospect. The editors and publisher" of the magazine, reads the announcement, "strongly support this decision" because there are "the results of an independent international commission". Which was named after the intervention of the English team in April.

University professor Marco Monticone, now on sick leave, is still director of the Brotzu Rehabilitation Department (which doesn't exist). While his studies fell under the ax of verification.